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Abstract Background Mesenchymal stromal cell derived extracellular vesicles (MSC-EVs) are a promising therapeutic for neuroinflammation. MSC-EVs can interact with microglia, the resident immune cells of the brain, to exert their immunomodulatory effects. In response to inflammatory cues, such as cytokines, microglia undergo phenotypic changes indicative of their function e.g. morphology and secretion. However, these changes in response to MSC-EVs are not well understood. Additionally, no disease-relevant screening tools to assess MSC-EV bioactivity exist, which has further impeded clinical translation. Here, we developed a quantitative, high throughput morphological profiling approach to assess the response of microglia to neuroinflammation- relevant signals and whether this morphological response can be used to indicate the bioactivity of MSC-EVs. Results Using an immortalized human microglia cell-line, we observed increased size (perimeter, major axis length) and complexity (form factor) upon stimulation with interferon-gamma (IFN-γ) and tumor necrosis factor-alpha (TNF-α). Upon treatment with MSC-EVs, the overall morphological score (determined using principal component analysis) shifted towards the unstimulated morphology, indicating that MSC-EVs are bioactive and modulate microglia. The morphological effects of MSC-EVs in TNF-α /IFN-γ stimulated cells were concomitant with reduced secretion of 14 chemokines/cytokines (e.g. CXCL6, CXCL9) and increased secretion of 12 chemokines/cytokines (e.g. CXCL8, CXCL10). Proteomic analysis of cell lysates revealed significant increases in 192 proteins (e.g. HIBADH, MEAK7, LAMC1) and decreases in 257 proteins (e.g. PTEN, TOM1, MFF) with MSC-EV treatment. Of note, many of these proteins are involved in regulation of cell morphology and migration. Gene Set Variation Analysis revealed upregulation of pathways associated with immune response, such as regulation of cytokine production, immune cell infiltration (e.g. T cells, NK cells) and morphological changes (e.g. Semaphorin, RHO/Rac signaling). Additionally, changes in microglia mitochondrial morphology were measured suggesting that MSC-EV modulate mitochondrial metabolism. Conclusion This study comprehensively demonstrates the effects of MSC-EVs on human microglial morphology, cytokine secretion, cellular proteome, and mitochondrial content. Our high-throughput, rapid, low-cost morphometric approach enables screening of MSC-EV batches and manufacturing conditions to enhance EV function and mitigate EV functional heterogeneity in a disease relevant manner. This approach is highly generalizable and can be further adapted and refined based on selection of the disease-relevant signal, target cell, and therapeutic product.

Context: Peripheral nerve blocks are widely accepted as the gold standard for providing perioperative and postoperative analgesia in lower limb surgeries. Aims: This study aimed to determine which block is better in terms of onset of action among ultrasound-guided femoral nerve block (USG FNB) and ultrasound-guided fascia iliaca compartment block (USG FICB) for positioning for spinal anesthesia in patients operated for proximal femur fracture and find the total duration of analgesia, total consumption of rescue analgesics, and complications. Settings and Design: This was a prospective, randomized, comparative, interventional, single-blinded study. Subjects and Methods: Patients in Group A (n = 43) were administered USG FNB with 15 mL of 0.25% bupivacaine and patients in Group B (n = 43) were administered USG FICB with 30 mL of 0.25% bupivacaine. The primary objective was to find out which nerve block was better in reducing pain associated with a sitting position for spinal anesthesia, and the secondary objective was to find the difference in the mean time of first rescue analgesia. Statistical Analysis: Data analysis was done using the Student’s t-test and Chi-square tests. Results: Before block administration, patients in Group A had a Visual Analog Scale (VAS) score of 7.65 ± 0.75, and patients in Group B had a VAS score of 7.79 ± 0.74 (P = 0.389). The primary objective was to achieve VAS < 3. It was 3 min in Group A and 5 min in Group B (P = 001). The secondary objectives were the duration of postoperative analgesia in Group A was 330.58 ± 28.16 min and in Group B was 482.33 ± 19.89 min (P < 0.001). The mean value of tramadol consumption in 24 h in both the study groups was comparable (P = 1.000). The anesthesiologist satisfaction score, patient satisfaction score, and proportion of side effects in both study groups were comparable. Conclusion: USG FICB is more efficacious. Although the onset of action delays by 2 min, it provides longer postoperative analgesia compared to USG FNB.

Due to their immunomodulatory function, mesenchymal stromal cells (MSCs) are a promising therapeutic with the potential to treat neuroinflammation associated with neurodegenerative diseases. This function is mediated by secreted extracellular vesicles (MSC-EVs). Despite established safety, MSC clinical translation has been unsuccessful due to inconsistent clinical outcomes resulting from functional heterogeneity. Current approaches to mitigate functional heterogeneity include ‘priming’ MSCs with inflammatory signals to enhance function. However, comprehensive evaluation of priming and its effects on MSC-EV function has not been performed. Furthermore, clinical translation of MSC-EV therapies requires significant manufacturing scale-up, yet few studies have investigated the effects of priming in bioreactors. As MSC morphology has been shown to predict their immunomodulatory function, we screened MSC morphological response to an array of priming signals and evaluated MSC-EV identity and potency in response to priming in flasks and bioreactors. We identified unique priming conditions corresponding to distinct morphologies. These conditions demonstrated a range of MSC-EV preparation quality and lipidome, allowing us to discover a novel MSC-EV manufacturing condition, as well as gain insight into potential mechanisms of MSC-EV microglia modulation. Our novel screening approach and application of priming to MSC-EV bioreactor manufacturing informs refinement of larger-scale manufacturing and enhancement of MSC-EV function.

Rift Valley fever virus (RVFV) is an encephalitic bunyavirus that can infect neurons in the brain. There are no approved therapeutics that can protect from RVFV encephalitis. Innate immunity, the first line of defense against infection, canonically antagonizes viruses through interferon signaling. We found that interferons did not efficiently protect primary cortical neurons from RVFV, unlike other cell types. To identify alternative neuronal antiviral pathways, we screened innate immune ligands and discovered that the TLR2 ligand Pam3CSK4 inhibited RVFV infection, and other bunyaviruses. Mechanistically, we found that Pam3CSK4 blocks viral fusion, independent of TLR2. In a mouse model of RVFV encephalitis, Pam3CSK4 treatment protected animals from infection and mortality. Overall, Pam3CSK4 is a bunyavirus fusion inhibitor active in primary neurons and the brain, representing a new approach toward the development of treatments for encephalitic bunyavirus infections.

In the realm of advancing energy storage technologies, the efficacy of natural biomass sources in mitigating environmental constraints has gained prominence. This study delves into the evolving landscape of energy storage devices, specifically batteries, super-capacitors, and the nascent domain of zinc-ion hybrid super-capacitors (ZIHSC). The focus centers on biomass-derived highly activated carbon, a burgeoning field of research esteemed for its diversity, environmental compatibility, distinctive structural attributes, and unique surface characteristics. This investigation presents a comparative analysis of activated carbons derived from ground nutshell (GS) in the context of ZIHSC applications. Emphasis is placed on the significance of a straightforward biochar synthesis process and subsequent chemical activation. The activated biochar, denoted as GS-H3PO4 and synthesized using H3PO4, exhibits a discernibly higher Brunauer Emmett Teller (B.E.T.) surface area when juxtaposed with pre-carbonized ground nutshell (GS-Biochar).The ZIHSC cell incorporating GS-H3PO4 manifests noteworthy energy density metrics, registering at 50.28 Wh Kg−1 (100 W Kg−1) and 11 Wh Kg−1 (2 kW Kg−1). Additionally, it demonstrates a specific capacitance of 199 F g−1 (2 mV s−1). These findings underscore the promising potential of H3PO4-derived activated carbon in optimizing cathode performance for Zinc-ion hybrid super-capacitors. This study contributes to the growing understanding of biomass-derived materials, offering insights into the nuanced interplay between synthesis methods and electrochemical properties, crucial for advancing sustainable energy storage solutions.

Accurate estimation of the state of charge (SoC) is crucial for optimizing battery performance, battery health estimation, and ensuring reliable operation. In recent years, deep learning techniques have shown promising results in capturing complex non-linear relationships between input features and estimated the SoC as they do not rely on battery models. However, a detailed comparison of these techniques is not available. Therefore, this paper presents a comprehensive comparison of SoC estimation using ANN (artificial neural network), LSTM (long short-term memory), BiLSTM (bidirectional LSTM), and GRU (gated recurrent unit) models applied to lithium-ion batteries. These models are trained using five distinct drive cycles and tested against four additional drive cycles from a publicly available dataset. The effectiveness is evaluated with RMSE (root mean squared error) and R2 score (coefficient of determination). The results provide insights into the applicability of ANN, LSTM, BiLSTM, and GRU for SoC estimation in lithium-ion battery systems, highlighting the advantages and limitations of each architecture. Additionally, the neuron effect is considered to examine the impact of the number of neurons in the hidden layer on the prediction of SoC. Comparing all models, it is observed that the BiLSTM network shows promising results, showing RMSE of 0.0097 and R2 value of 0.9987 when evaluated on one of the testing datasets, surpassing the performance of the other models. Further, the addition of temperature as a feature and the effect of external noise on the SoC estimation using the BiLSTM network are analyzed, highlighting the significance of accurate SoC estimation.

Peripheral arterial disease (PAD) affects 12 % of adult population and is increasing globally and in India. Peripheral arterial disease when associated with atherosclerosis in two or more other arterial beds such as coronary artery disease (CAD), mesenteric/renal artery and cerebrovascular disease (CVD), is known as polyvascular disease. The Reduction of Atherothrombosis for Continued Health (REACH) registry reported that 1 out of 6 patients had multi-vascular bed involvement. Progression of PAD to critical limb ischaemia (CLI) is seen in 1 % of affected patients per year, but patients who progress to CLI may have a 10- to 15-fold increased risk of cardiovascular death.The 2019 ECS/EAS guidelines for the management of dyslipidaemias have suggested that for primary or secondary prevention in very high risk, patients should follow a therapeutic regimen that achieves >50 % LDL-C reduction from baseline and an LDL-C goal of

Murine research has revealed a significant role for antibody responses in protection against Chlamydia reinfection. To explore potential humoral immune markers of protection elicited by Chlamydia trachomatis (CT) antigens in humans in the context of presumed clinical correlates of protection, we used both an IgG1-based ELISA and a conventional total IgG ELISA to evaluate antibody responses. We evaluated responses to five CT outer membrane proteins (PmpE, PmpF, PmpG, PmpH, and MOMP), along with other promising CT antigens (Pgp3 and HSP60), negative control antigens (RecO and AtpE), and CT elementary bodies (EBs) in sera from a well-characterized cohort of 60 women with different CT infection outcomes, including two outcomes that are likely clinical correlates of protective immunity: spontaneous resolution of infection and absence of reinfection after treatment. Furthermore, we used a flow cytometry-based assay to measure antibody-mediated phagocytosis by neutrophils in these sera. Results demonstrated that IgG1 ELISA displayed higher sensitivity than conventional total IgG ELISA in assessing antibody responses to CT EBs and antigens. Pgp3 IgG1 ELISA exhibited the highest sensitivity compared to IgG1 ELISA incorporating CT EBs or other antigens, confirming Pgp3 IgG1 ELISA as an ideal assay for CT antibody detection. Most (95%) sera from women with CT infection outcomes exhibited antibody-mediated phagocytosis of CT EBs, which was significantly correlated with IgG1 antibody responses to MOMP, Pgp3, HSP60, and PmpF. However, neither IgG1 responses to CT antigens and EBs nor antibody-mediated phagocytosis were associated with clinical correlates of protection. These findings suggest that neither CT IgG1 antibody detection nor antibody-mediated phagocytosis will be useful as immune correlates of protection against CT infection in humans.

Introduction: Plasmodium vivax (P. vivax) malaria is a major public health problem worldwide, particularly in the tropical and subtropical regions. Although P. vivax malaria is generally considered less severe than Plasmodium falciparum (P. falciparum) malaria, it can still cause severe illness, including severe anaemia, respiratory distress, and cerebral malaria, which can be fatal. Additionally, due to its relapsing nature it can further complicate treatment. Despite being a significant cause of morbidity and mortality, P. vivax malaria has received relatively less attention than P. falciparum malaria. Therefore, this study was designed to evaluate renal complications. Aim: To study the prevalence of renal involvement and its associations with clinical manifestations, laboratory parameters, and other complications in monoinfection of P. vivax malaria. Materials and Methods: This was a retrospective case-control study done over three years duration between April 2017 to March 2020. A total of 380 patients data were taken from hospital records of Hakeem Abdul Hameed Centenary (HAHC) hospital admitted with a diagnosis of P. vivax infection. Renal complications were assessed in all patients admitted with the diagnosis of P. vivax. Renal involvement was defined as per Acute Kidney Injury Network (AKIN) criteria for Acute Kidney Injury (AKI). For statistical calculations, data was analysed into two groups i.e., AKI and non AKI. Clinical, laboratory and other complications were assessed for statistical significance by t-test/Mann-Whitney test and for correlation between AKI and these variables univariate analysis was done initially followed by multivariate analysis. Results: In this study, male: female=1.8: 1. The prevalence of AKI was 22.59% with a male: female=2.1:1. Mean age in the AKI group was 35.89±14.69 years as compared to the non AKI group was 29.40±12.44 years (p-value=0.019). Renal involvement was significantly associated with rising hepatic transaminases (p-value=0.02, 0.018 for each variable). Leukopenia was protective for AKI; however rising leukocyte count was associated with increasing odds of renal involvement with Odd Ratio (OR) of 7.486 (p-value=0.001). AKI was strongly associated with increasing age, leukocytosis, and hyperbilirubinaemia. Whereas hepatic transaminases, hyponatraemia, cerebral malaria, acute respiratory distress syndrome, and thrombocytopaenia were weakly associated with AKI. Conclusion: P. vivax is not benign malaria anymore; complications should be anticipated and treated at an early stage.

The design and development of an alternative counter electrode (CE) using graphene-based low-cost material for the dye-sensitized solar cell (DSSC) is the major motivation of the current research to replace the traditional platinum counter electrode. Herein, we prepared reduced graphene oxide (rGO) and investigated it for an efficient CE in DSSC. The structural and morphological properties of rGO are analyzed using FESEM, TEM and Raman techniques. The performance of I3- reduction on the CE is characterized by the EIS Nyquist plot, cyclic voltammetry, and the Tafel curve. The measured electrochemical results suggested that rGO CE has a lower charge transfer resistance (Rct), higher cathodic current density (Jrd), and higher Tafel slope as compared to graphene oxide (GO) CE, revealing that rGO CE has good catalytic activity towards the I3- reduction.

Parturient with kyphoscoliosis poses a major challenge in the administration of spinal anaesthesia owing to changes in the anatomy of the spine and physiological changes associated with pregnancy. Recently, ultrasound guidance has proved to be a boon for regional anaesthesia techniques. We report the successful anaesthetic management of a 43 year-old primigravida with kyphoscoliosis who was posted for emergency caesarean section using an ultrasound-guided subarachnoid block.

This perspective is an attempt at describing the complex liaison between the Indian textile sector and the factors determining its export competitiveness. These dynamics range from logistics to the digital circular economy. In still greater detail, these could be listed as the geographical spread and the dynamism of exports, product combination and the level of specialization of exports, technical and skill levels across the industry as also efficiency, which in turn is influenced by the cost of production, delivery timetables, dependability of producers; and the image of the product brand and the exporter nation. Use of tools such as review of studies and Revealed Comparative Advantage (RCA) have been made so as to explain the theory of competitiveness in the Indian textile exports relative to its major competitors such as China, Vietnam, Bangladesh, Sri Lanka and Pakistan. The study addresses several important issues as to the competitiveness and challenges before the Indian textile sector as far as its export performance is concerned. It suggests some alternatives to the current logistics- centric competitiveness discourse, chiefly, sustainable and gendered aspects of trade. The main contention of this perspective is that if understood sincerely, a gender -friendly Digital Circular Economy could work wonders for one and all.

The industrial relations (IR) environment in India and its labour market, have been undergoing significant transformations in multiple domains for around two decades after the economic liberalization. Gillan and Lambert (2013) observe several restructurings at the workplace level in the country. These include, among others, farming out job functions or services to any third party through outsourcing, engaging contract labour in the organized sector, the tendency among managers to avoid acknowledging the right of trade unions to collectively bargain and the prevalence of voluntary retirement schemes for having numerical flexibility of the workforce.

Aluminum phosphide (ALP) poisoning is one of the most common and lethal poisonings with no antidote available till now. Inhalation or ingestion of ALP leads to the production of phosphine gas when exposed to moisture. We here report an adolescent female with alleged consumption of ALP available as celphos tablet, followed by severe metabolic acidosis and cardiogenic shock. Rapid timely initiation of venoarterial extracorporeal membrane oxygenation leads to intact neurological outcome and survival. Timely referral to higher center with extracorporeal life support facility is a key.

Pulmonary mass lesions are very commonly encountered in our practice. Sometimes they present as homogenous opacity on a Chest Xray or CT scan and sometimes as a collapsed lung. Most of them are malignant and some are benign also. Lung infections rarely present as endobronchial mass. Only histopathology can aid us in diagnosing. One rare disease that can present as an invasive mass lesion is Pulmonary actinomycosis. We present a case of Lung actinomycosis coinfected with Mycobacterium tuberculosis that presented to us with the complaint of right lung collapse and effusion due to endobronchial growth mimicking lung malignancy.

Lysosomes move along microtubule tracks, and Arl8b is known to stimulate their anterograde transport. Here, the authors identified RUFY3 as an Arl8b effector that interacts with dynein-dynactin to drive retrograde transport and perinuclear lysosome positioning.

Associations of HLA class II alleles with genital chlamydial infection outcomes have been reported, especially HLA DQB1*06. However, the potential role of DQB1*06 in influencing reinfection risk has still not been established. The purpose of this study was to determine whether the association of DQB1*06 with chlamydia reinfection was impacted by any other nearby HLA class II variants that were also associated with reinfection. We used next-generation sequencing to map HLA class II variants spanning the HLA-DQ and -DR loci. DQB1*06 as well as DQB1*04 were confirmed as significant predictors of chlamydia reinfection, when controlling for age and percent African ancestry. SKAT analysis revealed one region each in DRB1, DRB5, DQA2, and three intergenic regions that had variants associated with reinfection. Further analyses of these variants revealed that rs112651494 within DRB5 and an intergenic SNP rs617058 in DRB1:DQA1 were significantly associated with reinfection, but this did not impact the significance of the association of DQB1*06 or DQB1*04 with reinfection.

Context: The widely accepted caries risk assessment tools such as the Cariogram model needs modifications in the scoring of different factors for reliable results. Aims: The study was aimed to report the caries experience in 3-60 years of the Rajasthan population and to apply the newly derived average decayed exfoliated filled teeth/Decayed Missing Filled Teeth (deft/DMFT) scores in the Cariogram model to assess the caries risk. Settings and Design: The cross-sectional study was planned in the Department of Dentistry and a total of 500 participants were equally divided into five groups (3-6, 7-12, 13-30, 31-44, and 45-60 years) were included. Methods and Material: All participants were examined for caries detection using deft/DMFT, ICDAS, and CAST indices according to the predefined protocol. A single examiner evaluated the participants in a dental operatory and data was recorded. Statistical Analysis Used: One-Way ANOVA and Tukey's Post-Hoc tests were used to evaluate the significant difference between the groups of each caries index. Results: A statistically significant difference was observed between the mean deft/DMFT and CAST scores of 3-6, 7-12, and 13-30 age groups with the 45-60 years age group. Caries prevalence was highest (83%) in 31-44 and 45-60 year age groups and lowest (51%) in the 3-6 year age group. Conclusions: Caries experience scores increase as the age increases and the highest scores were observed in 31-44 and 45-60 year age groups and the lowest were observed in the 3-6 year age group. The average ICDAS and CAST scores were higher when compared to the deft/DMFT index.

Aim: The aim of this study was to assess and grade anaemia in antenatal women at a tertiary care hospital. Materials and Methods: This cross-sectional study was conducted on 151 participants over 4 months at All India Institute of Medical Sciences (AIIMS), Rishikesh, a tertiary care hospital in Uttarakhand, India. Extensive work on quantifying daily nutritional intake and requirement was done to estimate antenatal women's nutritional status suffering from anaemia. Results: The proportion of anaemia among pregnant women was 37.09%, with mean haemoglobin of 11 g/dl, mode and median of 11.3 g/dl with higher and moderate anaemia than mild. It was in direct proportion with the number of abortions, gravid status and trimester of pregnancy. There was a protein deficit of 30–60% in 73.2% of the anaemic patients. Iron tablets were taken regularly by 85.5% of anaemic patients and 87.1% of non-anaemic patients. None of the anaemic patients met their 100% calorie requirement. The least calorie deficit was found to be 14.4%. A calorie deficit of 30–60% was found in 75% of the anaemic patients. Patients with severe anaemia had a calorie deficit of 40–60%. Discussion: Poverty, ignorance and non-availability of resources are the key factors underlying this condition. The lacunae in the delivery chain of beneficence to antenatal women offered by the government need to be looked at. Family planning has a pivotal role in controlling anaemia, as a high frequency of abortions and pregnancies were associated with anaemia.

Around the world, employers seek graduates with collaboration, teamwork, interpersonal, communication, and project management skills worldwide. Project-based learning (PBL) helps foster these essential professional skills by providing learning opportunities in an environment of mutual investigation. Collaboration is integral to PBL, but often advantages of collaboration are not the focal point of discussion. This study focuses on creating a collaborative learning environment by introducing a real-world project under PBL instructional strategy to check its efficacy in developing some essential professional skills in graphic design education. The project was introduced in 2019 in the Publication Design course undertaken by 35 students enrolled in an undergraduate graphic design programme in India. The study employed mixed-method research in the form of a survey questionnaire followed by semi-structured interviews. The study results show that PBL helps foster the skills mentioned earlier to prepare students for the 21st-century workplace. Joint efforts by students in projects in graphic design education develop multiple skills much needed in the current workplace scenario.

Entrepreneurial intention plays a decisive role in the process of becoming an entrepreneur. It is not only the prerequisite for establishing a business but it also influences an individual’s behavior. This study aims to investigate the impact of three key personality traits of a prospective entrepreneur (entrepreneurial passion, creativity, and self-efficacy) in shaping their entrepreneurial intention. It is proposed that entrepreneurial passion, creativity, and self-efficacy positively influence entrepreneurial intention. Primary data were collected from 408 Chartered Accountancy (CA) students of the National Capital Region (NCR) of India with the help of a structured questionnaire. The cluster sampling method was used to select the sample from the targeted population. The data were analyzed using structural equation modeling (SEM). The results establish that the entrepreneurial intention of CA students is significantly influenced by their creativity, entrepreneurial passion, and self-efficacy, as all three traits allow an entrepreneur to identify opportunities with profit potential. A student who is passionate, creative, and confident in exploiting the new business idea will develop an intention to become an entrepreneur. The present study contributes to the literature by investigating the entrepreneurial intention of CA students, which has not been explored earlier. The significance of this study facilitates academicians and accounting organizations to focus on the personality traits of students, which helps in developing entrepreneurial intention in them.

A research study was carried out to develop a RTS beverage by exploiting the nutritional and organoleptic properties of bael fruit pulp. Six treatment combinationsof bael RTS with 10, 15 and 20% of pulp concentration and 10 and 15°B of TSS were prepared based on the review of literature. The biochemical and organoleptic properties of the prepared RTS were evaluated during storage. The pH, ascorbic acid and antioxidant activity of the RTS decreased with the storage, while acidity and total sugars increased. Results of the sensory evaluation showed that there was a significant difference between treatments in terms of color, flavor, taste, body and overall acceptability. From the results of quality assessments, the formulated bael RTS beverage with 15% pulp and 15°B TSS was found to be superior and suitable for consumption up to 12 weeks without any significant changes in the quality characteristics.

Flexible electronic devices find wide application in wearable electronics and foldable gadgets. This article reports chemical vapor deposited (CVD) few-layers graphene for a solid-state flexible supercapacitor device. Raman spectroscopy analysis reveals up to five layers in the graphene samples. Polyvinyl alcohol-Na2SO4 hydrogel membrane is used as a gel polymer electrolyte (GPE). 50 nm thick silver (Ag) deposited on polyethylene tere­phthalate (PET) through E-beam deposition served as the flexible current collector for the device. Galvanostatic charge-discharge (GCD) executed on the fabricated device to ana­lyze its electrochemical performance yielded a specific areal capacitance of 15.3 mF cm-2 at 0.05 mA cm-2 current density. The obtained power density of the fabricated device is 0.53 µWh cm-2 at a power density of 25 µW cm-2.

The topology of metabolic networks is recognisably modular with modules weakly connected apart from sharing a pool of currency metabolites. Here, we defined modules as sets of reversible reactions isolated from the rest of metabolism by irreversible reactions except for the exchange of currency metabolites. Our approach identifies topologically independent modules under specific conditions associated with different metabolic functions. As case studies, the E.coli iJO1366 and Human Recon 2.2 genome-scale metabolic models were split in 103 and 321 modules respectively, displaying significant correlation patterns in expression data. Finally, we addressed a fundamental question about the metabolic flexibility conferred by reversible reactions: "Of all Directed Topologies (DTs) defined by fixing directions to all reversible reactions, how many are capable of carrying flux through all reactions?". Enumeration of the DTs for iJO1366 model was performed using an efficient depth-first search algorithm, rejecting infeasible DTs based on mass-imbalanced and loopy flux patterns. We found the direction of 79% of reversible reactions must be defined before all directions in the network can be fixed, granting a high degree of flexibility.

Neurocysticercosis is the most prevalent parasitic infection in developing countries, caused by the encysted larvae of taenia solium. It predominantly affects the brain alone or both the brain and the spinal cord. In spinal cysticercosis, the thoracic cord is most commonly involved. Isolated involvement of the cervical spinal cord is very rare. Authors here, report a case of 19-year-old male patient with intramedullary cysticercosis in the cervical cord. The lesion was diagnosed with magnetic resonance imaging and serology. Albendazole and steroids were used to treat the patient medically.

Fibrous dysplasia is a benign, congenital skeletal disorder which leads to the formation of fibro-osseous intramedullary bone lesions. Clival fibrous dysplasia is a rare variant which commonly presents asymptomatically with no findings on examination and is often picked up incidentally on radiological investigation. A 39-year-old female presented with a sudden onset headache of 3 days’ duration alongside diplopia and right lower limb weakness upon examination. Computerized tomography head scan revealed an expansile clivus with a ground-glass appearance, magnetic resonance imaging brain scan revealed a predominantly hypointense signal on T1- and T2-weighted images and subsequent whole-body bone imaging confirmed the diagnosis of monostotic clival fibrous dysplasia. This case highlights the importance of considering monostotic clival fibrous dysplasia as a differential diagnosis in patients presenting with sudden onset symptoms of headache alongside cranial and peripheral nerve involvement, when other more sinister causes have been excluded.

The positron impact cross-sections of pyrimidine molecules are reported from 1 eV to 5000 eV. These cross-sections include differential elastic, integral elastic, and direct ionisation. The elastic cross-sections are computed using the single-centre expansion scheme whereas the direct ionisation cross-sections are obtained using the binary-encounter-Bethe formula. The integral and differential cross-sections exhibit consistency with the experimental and other theoretical results. The direct ionisation cross-sections, which are reported for the first time, are compared with the experimental inelastic cross-sections (the sum of excitation and ionisation) to assess the trends in theoretically computed ionisation cross-sections and with the corresponding results for the electrons. The incoherently summed elastic and ionisation cross-sections match very well with the total cross-sections after 40 eV indicating the minimal impact of the positronium formation and electronic excitation processes. Based on this study, we recommend that the experimental data of the inelastic cross-sections reported by Palihawadana et al. be revisited.

In parallel with a steady rise in cancer incidence worldwide, the scientific community is increasingly focused on finding novel, safer and more efficient modalities for managing this disease. Over the past decades, natural products have been described as a significant source of new structural leads for novel drug candidates. Scutellaria root is one of the most studied natural products because of its anticancer potential. Besides just describing the cytotoxic properties of plant constituents, their molecular mechanisms of action in different cancer types are equally important. Therefore, this review article focuses on the role of the Scutellaria flavones wogonin, baicalein, baicalin, scutellarein and scutellarin in regulating the autophagic machinery in diverse cancer models, highlighting these molecules as potential lead compounds for the fight against malignant neoplasms. The knowledge that autophagy can function as a dual-edged sword, acting in both a pro- and antitumorigenic manner, further complicates the issue, revealing an amazing property of flavonoids that behave either as anti- or proautophagic agents.

Introduction: The announcement of a nationwide lockdown in India in March 2020 in response to the CoVID-19 pandemic led an exodus of migrant workers back to their homes. The significant adverse impact of this event in its early phase on these reverse migrants has been well documented. With the passage of several months, these reverse migrants eventually reached their homes and re-entered their own communities. This study was conducted amongst a rural community on the interior regions of Almora in hill state of Uttarakhand. Aim: It aims to assess the impact of the later phase of the CoVID-19 pandemic and lockdown on the reverse migrants, and compare this impact with the residents, who have never migrated. Methodology: Door-to-door survey was conducted in the study population, 5-9 months after the lockdown was announced. The participants were matched and grouped into residents and reverse migrants and were evaluated on PHQ-9, GAD-7, IES, and BRIEF-COPE to assess the impact on the participants. Results: No significant depression or anxiety was found in the reverse migrants group, even though the impact of the pandemic and lockdown was felt more by them as compared to the residents group. In addition, there was no significant difference between the two groups for depression or anxiety. Conclusion: These findings can be attributed to factors such as social support from the community members, engagement in work and the use of approach based coping mechanisms.

Conflicts and humanitarian crises lead to serious mental health disorders, including depression, anxiety, stress, and cognitive decline. Exposure to these circumstances in early life can lead to the development of disorders such as mild cognitive impairment, dementia, and Alzheimer's disease (AD), for which no treatments are available. In this review, various research papers have been compiled to develop an understanding about mental health of population affected due to wars and conflicts and how stress and depression can accelerate the development of dementia and AD. Due to failure of drugs in the treatment of dementia and AD, yoga and mindfulness-based approach has been proposed for future investigations. Although studies have shown that yoga and mindfulness can be helpful in the management of stress, anxiety, depression, and posttraumatic stress disorder in the war-afflicted areas, limited mechanistic studies in yoga and mindfulness remain the chief cause precluding its clinical application in such warzones. The molecular studies in the field of yoga can be undertaken by targeting these warzones. This review provides a scientific evaluation of mind–body techniques as a justification for mental health rehabilitation in the war-afflicted zones in face of failed clinical trials for various drugs. This may help reduce the risk of developing dementia and AD in this susceptible population.

Heavy metals (HMs) and radionuclides are released through geological and anthropogenic activities and enter the environment through wastewater, soil and sediment. Large amounts of Pb (>1000 ppm), Zn (>4000 ppm) and Cd (40–400 ppm) have recently been reported in soils near Picher, USA. These inorganic pollutants cannot be degraded and cause damage to the vital human organs. Different industrial and municipal solid waste was a major source of HMs in soil, including airborne aerosols. In the same manner, nuclear waste and radioactive materials used (e.g., medical facilities) or released in different processes contribute to the environmental pollution of radionuclides. The release of such HMs ions from different sources leads to mutagenesis, carcinogenesis and poses serious risks to the living organisms. As a result, proper management of waste from these sources, as well as environmentally friendly remediation methods, is imperative. However, recent studies have shown that it is more difficult to remove HMs and radionuclides from the soil, but they can be effectively neutralized or converted into a less toxic metabolites. The combination of a unique plant-microbe system plays a key role in the remediation process. However, new bioremediation methods are now being used to eliminate HMs and radionuclides. Microbes are capable of bio-transforming, bio-sorbing and biomineralizing HMs and radionuclides through their inherent catabolic process. Enhancing phytoremediation using different strategies for the remediation of HMs and radionuclides is necessary to ensure that the land resource is safe, fertile and productive for sustainable use.

COVID-19, a viral disease fatal yet preventable is caused by a newly identified β-corona virus. The people most vulnerable to this infection are the ones with a prior history of diseases, low immunity, or either too old or too young (particularly children and infants). In the context of the virus’s impact on the pediatric age groups, this article highlights some of the challenges and guidelines on managing it. Pediatric groups, like everyone else, are highly vulnerable to the infection by COVID-19. The lower number of pediatric patients involved at the beginning of a pandemic does not necessarily mean that children are less vulnerable to the infection. However, the good news is that the disease usually has a mild course and appropriate prevention and oral health management in children can help to keep it at bay. Adherence to simple compliance and safety protocols can go a long way. For instance, in the course of some of the procedures performed by a pediatric dentist, there may be a risk of aerosols being generated, which in turn can lead to cross-infection making the patient vulnerable to contracting COVID-19. In such a situation, parents are advised to take good home-based care and take telemedicine consultation immediately. This article lays a concrete emphasis on reviewing the limited published literature that is specific to the pediatric population regarding epidemiology, pathogenesis, diagnosis, and treatment modalities of COVID-19. It analyzes the potential risk from COVID-19 associated with pediatric dental treatment. In addition, it presents a series of considerations on potential oral prevention strategies on the management of urgent and non-urgent dental procedures in a context of disease transference control. This literature review also gives an insight for the private practitioner to have healthier management in the pediatric fraternity during this highly contagious COVID-19 pandemic.

OBJECTIVES:. To describe the prevalence, associated risk factors, and outcomes of serious neurologic manifestations (encephalopathy, stroke, seizure, and meningitis/encephalitis) among patients hospitalized with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. DESIGN:. Prospective observational study. SETTING:. One hundred seventy-nine hospitals in 24 countries within the Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study COVID-19 Registry. PATIENTS:. Hospitalized adults with laboratory-confirmed SARS-CoV-2 infection. INTERVENTIONS:. None. RESULTS:. Of 16,225 patients enrolled in the registry with hospital discharge status available, 2,092 (12.9%) developed serious neurologic manifestations including 1,656 (10.2%) with encephalopathy at admission, 331 (2.0%) with stroke, 243 (1.5%) with seizure, and 73 (0.5%) with meningitis/encephalitis at admission or during hospitalization. Patients with serious neurologic manifestations of COVID-19 were older with median (interquartile range) age 72 years (61.0–81.0 yr) versus 61 years (48.0–72.0 yr) and had higher prevalence of chronic medical conditions, including vascular risk factors. Adjusting for age, sex, and time since the onset of the pandemic, serious neurologic manifestations were associated with more severe disease (odds ratio [OR], 1.49; p < 0.001) as defined by the World Health Organization ordinal disease severity scale for COVID-19 infection. Patients with neurologic manifestations were more likely to be admitted to the ICU (OR, 1.45; p < 0.001) and require critical care interventions (extracorporeal membrane oxygenation: OR, 1.78; p = 0.009 and renal replacement therapy: OR, 1.99; p < 0.001). Hospital, ICU, and 28-day mortality for patients with neurologic manifestations was higher (OR, 1.51, 1.37, and 1.58; p < 0.001), and patients had fewer ICU-free, hospital-free, and ventilator-free days (estimated difference in days, –0.84, –1.34, and –0.84; p < 0.001). CONCLUSIONS:. Encephalopathy at admission is common in hospitalized patients with SARS-CoV-2 infection and is associated with worse outcomes. While serious neurologic manifestations including stroke, seizure, and meningitis/encephalitis were less common, all were associated with increased ICU support utilization, more severe disease, and worse outcomes.

OBJECTIVES:. To describe hospital variation in use of “guideline-based care” for acute respiratory distress syndrome (ARDS) due to COVID-19. DESIGN:. Retrospective, observational study. SETTING:. The Society of Critical Care Medicine’s Discovery Viral Infection and RESPIRATORY ILLNESS UNIVERSAL STUDY COVID-19 REGISTRY. PATIENTS:. Adult patients with ARDS due to COVID-19 between February 15, 2020, and April 12, 2021. INTERVENTIONS:. Hospital-level use of “guideline-based care” for ARDS including low-tidal-volume ventilation, plateau pressure less than 30 cm H2O, and prone ventilation for a Pao2/Fio2 ratio less than 100. MEASUREMENTS AND MAIN RESULTS:. Among 1,495 adults with COVID-19 ARDS receiving care across 42 hospitals, 50.4% ever received care consistent with ARDS clinical practice guidelines. After adjusting for patient demographics and severity of illness, hospital characteristics, and pandemic timing, hospital of admission contributed to 14% of the risk-adjusted variation in “guideline-based care.” A patient treated at a randomly selected hospital with higher use of guideline-based care had a median odds ratio of 2.0 (95% CI, 1.1–3.4) for receipt of “guideline-based care” compared with a patient receiving treatment at a randomly selected hospital with low use of recommended therapies. Median-adjusted inhospital mortality was 53% (interquartile range, 47–62%), with a nonsignificantly decreased risk of mortality for patients admitted to hospitals in the highest use “guideline-based care” quartile (49%) compared with the lowest use quartile (60%) (odds ratio, 0.7; 95% CI, 0.3–1.9; p = 0.49). CONCLUSIONS:. During the first year of the COVID-19 pandemic, only half of patients received “guideline-based care” for ARDS management, with wide practice variation across hospitals. Strategies that improve adherence to recommended ARDS management strategies are needed.

Background and Study Aim The main aim of the study was to determine the level of optimism and life satisfaction among men of different ages who professionally or recreationally practice judo and Brazilian jiu-jitsu. Material and Methods The study involved 43 judo athletes, 43 Brazilian jiu-jitsu athletes (BJJ) and 42 persons in a control group (homogenously selected in terms of sex and age). The study used the SWLS scale to determine the satisfaction with life and the LOT-R test to determine the level of optimism. Descriptive parametric statistics were presented in order to show the analysed variables. Due to the number of subjects in groups, nonparametric statistics were used in the analysis – to analyse the differences, the Anova Kruskal-Wallis test; to analyse correlations between variables, the agglomerations method using Euclidean distances (single bond in space). In the analysis of the magnitude of the influence of variables on life satisfaction and optimism, parameter β was used – the significance of the parameter (p) was based on Wald's statistics. Results Analysis of intergroup differences for the judo, BJJ, and control groups revealed significant differences in education, social status, professional work, and health condition. The compared psychological variables – quality of life and life orientation in terms of standardised results did not reveal significant differences; however, the dichotomous division of the quality of life allowed indicating the distinctness of the compared groups. The analysis of multiple comparisons revealed that the differences only concerned the characteristics of the judo and the control groups, while the BJJ and the judo groups significantly differed in the quality and the length of their sports careers. Systems of characteristic features to explain the quality of life and life orientation were also searched for – the agglomerations method allowed indicating the distinctness of the BJJ and the judo groups in terms of the length of their sports careers. Based on the conducted logistic regression analysis, the likelihood of high or low quality of life and of life orientation and optimism in both groups of athletes has been identified, and differences consistent with previous observations have been indicated. Conclusions The subjects involved in combat sports significantly differ from those who do not practice sports in terms of education, social status, work situation and health assessment. The presence of high or low life satisfaction differentiates the compared groups.

Surgical treatment of deep or difficult to access lesions represents a unique and significant challenge for pediatric neurosurgeons. The introduction of stereotactic magnetic resonance-guided laser interstitial thermal therapy (LITT) over the last decade has had a dramatic impact on the landscape of pediatric neurosurgery. LITT provides a safe and effective option for children with epilepsy from hypothalamic hamartoma that represents a ground-breaking new therapy for a condition which was historically very difficult to treat with previous neurosurgical techniques. LITT has also been used as an alternative surgical technique for mesial temporal sclerosis, focal cortical dysplasia, MR-negative epilepsy, cavernoma-related epilepsy, insular epilepsy, and corpus callosotomy among other epilepsy etiologies. In some cases, LITT has been associated with improved cognitive outcomes compared to standard techniques, as in mesial temporal lobe epilepsy. Initial experiences with LITT for neuro-oncologic processes are also promising. LITT is often attractive to patients and providers as a minimally invasive approach, but the differences in safety and clinical outcome between LITT and traditional approaches are still being studied. In this review, we examine the emerging indications and clinical evidence for LITT in pediatric neurosurgery.

Background and Aims: Faith healing is a method of treating illnesses through the exercise of faith rather than medical methods. The current study was done with the objective to find out demographic variables of faith healers, various conditions for which the people approach them, various practices and processes used and to look for scope of integrated approach to healthcare with faith healers. Settings and Design: RHTC village was a sub center village of PHC Morad. Hence, for the study, all the villages which comes under PHC Morad were selected. The design of the study was a cross-sectional study. Methods and Material: The study was a cross sectional study where faith healers were interviewed based on a semi structured questionnaire comprising of both close and open-ended questions. Statistical Analysis Used: Absolute numbers. Results: Different reasons for which the persons usually came for ranged from supernatural possession, unemployment, family problems etc., and various different processes were used by these healers to solve the problems included giving charms and amulets, personal sacrifices like “baddha” (Nischay/praan) and many others. Conclusion: The study concludes that faith healers in many conditions and situations became the first point of contact as the faith of the community in these faith healers is deeply rooted.

Platelet lymphocyte ratio (PLR) is a novel marker of inflammation that has gained popularity, especially in prognostication of cardiac diseases and malignant conditions. Several studies have examined the relationship between PLR and disease-specific mortality but none has examined this relationship with all-cause mortality in general population. Therefore, we examined the relationship between PLR and all-cause mortality using data from the National Health and Nutrition Examination Survey (NHANES) from the year 1999 to 2010. The role of PLR in predicting all-cause mortality was evaluated using Cox proportional hazards model adjusting for age, race, gender, smoking history, diabetes, hypertension, serum cholesterol, estimated glomerular filtration rate, serum c-reactive protein, and body mass index. Differential effect of age was examined using difference of differences analysis. Of the 27321 individuals, 2581 died during 171223 person-year follow-up. Mean PLR was significantly higher in participants who died than those who were living at the end of follow-up (145.7 vs. 133.0, respectively, p

Introduction: Purpose of this research is to assess the relationship between long-term pediatric liquid medicines (PLMs) consumption and dental caries in 2–12-years-old chronically ill children. Methods: A cross-sectional study was performed in a public pediatric hospital in India for a period of 6 months. A total of 455 children aged 2–12 years old with various chronic diseases who were receiving PLMs for more than 6 months were selected as the subjects in this study and compared with 531 children of similar age group and diseases who received other forms of medication. Dental caries was measured by DMFT/dmft and data collected were analyzed with SPSS (17th version) using statistical tests such as t-test and one-way ANOVA. Univariable logistic regression was used where the significance was fixed at a a p value of less than 0.001. Results: Children on PLMs had an increased risk of dental caries than those on other forms of medications (OR: 3.142, 95% CI: 2.37–4.15, p < 0.001). The prevalence of dental caries was higher (77.8%) in children consuming PLMs when compared to other forms of medication (52.7%). The mean DMFT and dmft scores were significantly higher in the study group when compared to the control group (p = 0.001). Conclusion: Long-term consumption of pediatric liquid medicines containing sucrose as a risk factor for dental caries among chronically ill children. sugar free options has to be used during prescription to prevent medication-triggered caries. Keywords: Paediatric liquid medicine, medication-triggered caries, sugar-free medication

Online courses often include interface designs that do not support a positive learner experience. Literature shows a variety of heuristics to detect issues of online courses. While heuristic-based inspection of usability is a dominant method for evaluating digital systems, these methods cannot be easily transferred to online courses. To close this gap, we identified an initial set of social, technical, and pedagogical related items (STP) heuristics based on literature. Next, we analyzed this set using empirical data from two online courses. In total, we analyzed 195 problems with the goal to substantiate a final set of 14 STP heuristics. This new set allows for efficiently evaluating online courses by supporting evaluators and instructional designers in uncovering the most crucial issues and improving the learner experience. Finally, based on this work, we discuss a definition of learner experience for the emerging field of learner experience design and research.

The graphic design profession has evolved and moved far beyond its past skill-centric connotations. Today’s graphic designers are no longer expected to be merely skilled hands working in silos; instead, they are expected to work with multidisciplinary teams, equipped to handle new challenges of the profession and as professionals. Literature indicates towards lack of preparedness of fresh graphic design graduates to meet the demands of the rapidly changing professional landscape. Thus, it is necessary for design education-curriculum designers, educators and policymakers to design and implement learning environments towards the development of some essential professional skills in view of contemporary work scenarios. This study attempts to ascertain from Indian professionals who employ fresh graphic design graduates, the need for fostering collaboration & teamwork, communication, critical thinking, problem-solving, project planning & management skills in graphic design students to thrive in the workplace. The information is necessary to facilitate the design education fraternity for developing strategies to foster these skills in the academic space. The study results indicate strong support from the employers towards the aforementioned skills.

Knowledge of seed germination behaviour of different seed sources of tree species is useful in selecting the most responsive and adaptive ones for propagation and germplasm conservation. The wild Himalayan pear (Pyrus pashia Buch-Ham ex D. Don) produces highly nutritious edible fruits that are consumed by local communities. The populations of the species are threatened due to exploitation and lack of adequate conservation programmes. The study was conducted to examine the germination response of P. pashia seeds from two sources (S1-Champawat and S2-Pithoragarh) in Uttarakhand state of India, to different GA3 treatment and also to assess the viability and longevity of the seeds in cold storage (5 °C) for three years. In both sources germination percent (GP) increased significantly under GA3 treatment and speed of germination was also enhanced (reduction in mean germination time). In Source, 1 GP increased under all GA3 application, highest being 94% under GA3 500 ppm treatment. In Source 2, GP of seeds doubled under 100 ppm GA3 treatment while its higher concentrations did not improve the germination. However, the differences observed in germination between the seed sources could be due to differences in the dormancy levels and/or sensitivity to dormancy breaking elements across their geographical range. Thus, exogenous application of GA3 is suggested for enhancing the germination in seeds of P. pashia. Seeds responded to cold storage by increased germination with duration, i.e. highest after three years in storage, indicating that the seeds got the required chilling treatment for overcoming dormancy.

IMPORTANCE:. At the start of the coronavirus disease 2019 pandemic, medications repurposed for management of coronavirus disease 2019 were used in the absence of clinical trial evidence. OBJECTIVES:. To describe the variation and evolution in use of repurposed medications for coronavirus disease 2019. DESIGN, SETTING, AND PARTICIPANTS:. Observational cohort study of adults hospitalized with coronavirus disease 2019 between February 15, 2020, and April 12, 2021, across 76 United States and international hospitals within the Society of Critical Care Medicine’s Discovery Viral Infection and Respiratory Illness Universal Study coronavirus disease 2019 registry. MAIN OUTCOMES AND MEASURES:. Hospital variation was quantified using multivariable adjusted random effects logistic regression models and unsupervised clustering. Repurposed medications included antivirals, corticosteroids, hydroxychloroquine, immunomodulators, and therapeutic dose anticoagulants. RESULTS:. Among 7,069 adults hospitalized with coronavirus disease 2019, 1,979 (28%) received antivirals, 2,876 (41%) received corticosteroids, 1,779 (25%) received hydroxychloroquine, 620 (9%) received immunomodulators, and 2,154 (31%) received therapeutic dose anticoagulants. Contribution of hospital site to risk-adjusted variation was 46% for antivirals, 30% for corticosteroids, 48% for hydroxychloroquine, 46% for immunomodulators, and 52% for therapeutic dose anticoagulants. Compared with the early pandemic, the later pandemic practice phenotypes converged with increased use of antivirals (odds ratio, 3.14; 95% CI, 2.40–4.10) and corticosteroids (odds ratio, 5.43; 95% CI, 4.23–6.97), with decreased use of hydroxychloroquine (odds ratio, 0.02; 95% CI, 0.01–0.04) and immunomodulators (odds ratio, 0.49; 95% CI, 0.34–0.70). There was no clinically significant change in the use of therapeutic dose anticoagulants (odds ratio, 1.01; 95% CI, 1.01–1.02). There were no differences in risk-adjusted mortality between hospitals with high rates of repurposed medication use compared with hospitals with low rates of use. CONCLUSIONS AND RELEVANCE:. Hospital variation in the use of repurposed medications varied widely across hospitals early in the pandemic and later converged with the emergence of randomized clinical trials. Platforms developed for rapid activation and enrollment in clinical trials of repurposed medications are needed prior to the next pandemic to expedite effective, evidence-based practice.

Phloretin is a natural dihydrochalcone found in many fruits and vegetables, especially in apple tree leaves and the Manchurian apricots, exhibiting several therapeutic properties, such as antioxidant, antidiabetic, anti-inflammatory, and antitumor activities. In this review article, the diverse aspects of the anticancer potential of phloretin are addressed, presenting its antiproliferative, proapoptotic, antimetastatic, and antiangiogenic activities in many different preclinical cancer models. The fact that phloretin is a planar lipophilic polyphenol and, thus, a membrane-disrupting Pan-Assay Interference compound (PAIN) compromises the validity of the cell-based anticancer activities. Phloretin significantly reduces membrane dipole potential and, therefore, is expected to be able to activate a number of cellular signaling pathways in a non-specific way. In this way, the effects of this minor flavonoid on Bax and Bcl-2 proteins, caspases and MMPs, cytokines, and inflammatory enzymes are all analyzed in the current review. Moreover, besides the anticancer activities exerted by phloretin alone, its co-effects with conventional anticancer drugs are also under discussion. Therefore, this review presents a thorough overview of the preclinical anticancer potential of phloretin, allowing one to take the next steps in the development of novel drug candidates and move on to clinical trials.

It is well known that, historically, plants have been an important resource of anticancer agents, providing several clinically approved drugs. Numerous preclinical studies have shown a strong anticancer potential of structurally different phytochemicals, including polyphenolic constituents of plants, flavonoids. In this review article, suppressing effects of equol in different carcinogenesis models are unraveled, highlighting the mechanisms involved in these anticancer activities. Among flavonoids, daidzein is a well-known isoflavone occurring in soybeans and soy products. In a certain part of population, this soy isoflavone is decomposed to equol under the action of gut microflora. Somewhat surprisingly, this degradation product has been shown to be more bioactive than its precursor daidzein, revealing a strong and multifaceted anticancer potential. In this way, it is important to bear in mind that the metabolic conversion of plant flavonoids might lead to products that are even more efficient than the parent compounds themselves, definitely deserving further studies.

IMPORTANCE:. Even with its proclivity for older age, coronavirus disease 2019 has been shown to affect all age groups. However, there remains a lack of research focused primarily on the young adult population. OBJECTIVES:. To describe the epidemiology and outcomes of coronavirus disease 2019 and identify the risk factors associated with critical illness and mortality in hospitalized young adults. DESIGN, SETTINGS, AND PARTICIPANTS:. A retrospective cohort study of the Society of Critical Care Medicine’s Viral Infection and Respiratory Illness Universal Study registry. Patients 18–40 years old, hospitalized from coronavirus disease 2019 from March 2020 to April 2021, were included in the analysis. MAIN OUTCOMES AND MEASURES:. Critical illness was defined as a composite of mortality and 21 predefined interventions and complications. Multivariable logistic regression was used to assess associations with critical illness and mortality. RESULTS:. Data from 4,005 patients (152 centers, 19 countries, 18.6% non-U.S. patients) were analyzed. The median age was 32 years (interquartile range, 27–37 yr); 51% were female, 29.4% Hispanic, and 42.9% had obesity. Most patients (63.2%) had comorbidities, the most common being hypertension (14.5%) and diabetes (13.7%). Hospital and ICU mortality were 3.2% (129/4,005) and 8.3% (109/1,313), respectively. Critical illness occurred in 25% (n = 996), and 34.3% (n = 1,376) were admitted to the ICU. Older age (p = 0.03), male sex (adjusted odds ratio, 1.83 [95% CI, 1.2–2.6]), and obesity (adjusted odds ratio, 1.6 [95% CI, 1.1–2.4]) were associated with hospital mortality. In addition to the above factors, the presence of any comorbidity was associated with critical illness from coronavirus disease 2019. Multiple sensitivity analyses, including analysis with U.S. patients only and patients admitted to high-volume sites, showed similar risk factors. CONCLUSIONS:. Among hospitalized young adults, obese males with comorbidities are at higher risk of developing critical illness or dying from coronavirus disease 2019.

The triad of palpitation, angina, and murmur is a classical feature of cardiac pathology. However, their presence sometimes uncovers a thyroid etiology. Identification well in time decreases out-of-pocket expenditures on illness and suffering. We report a case of a 40-year-old woman who presented with fever with chills, vomiting, palpitations, and shortness of breath for the past month. Also, she described chest pain as typical of angina. Multiple diagnoses were made elsewhere, but none of the treatments resulted in the resolution of symptoms. ST changes were suggestive of ischemic pathology, cardiac MRI done showed up hypertrophied myocardium. After a negative blood culture for infective endocarditis and serology sought for fever work-up, suspicious cardiac examination with a murmur, and an abnormal thyroid profile with a thyroid scan, led to a diagnosis of Graves' disease. This case defines the triad in a noncardiac patient and emphasizes what a thyroid disease does to the heart.

The ionization data of a neutral molecule are crucial to model the energy deposition and dissociative ionization process. We study theoretically the electron impact ionization process and report on the dissociative ionization cross sections of the tungsten hexafluoride cations invoking the modified-binary-encounter-Bethe model. In this model, the binary-encounter-Bethe model is modified by applying the transformation to the binding energies of the molecular orbitals and then normalizing the partial ionization cross sections of the cations using the branching ratios. The normalization is performed at a particular energy and ensures that the branching ratios of different fragments are summed to unity. The model yielded satisfactory results for both the singly and doubly ionized ions. The approach validates the results of Basner et al. The advantages and limitations of this model are also discussed. This work corroborates the importance of mass spectrometry data in the proper understanding of the ionization process.